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Parents' burden: Lack of resources adds to challenges of caring for the mentally ill

Jim Nichols holds the last photo of his family together, taken not long after his son graduated from high school. He and his wife, Janet, are now separated, and his son, Ryan, is serving a prison sentence for stabbing an 80-year-old man at a King Soopers. Ryan Nichols will be eligible for parole in 12 years. (Joe Amon, The Denver Post)

RYAN PATRICK NICHOLS, 26, was arrested in Westminster after he stabbed a King Soopers employee going into the store. The victim Dean Withers, 74, is recovering. (HANDOUT | )

News coverage of mass shootings, such as Aurora last July and Tucson two years ago, triggers such sorrow that Jim Nichols often must look away.

"It depends on my mood," said Nichols, a special-education teacher for Jeffco Public Schools. "This time, I didn't even look at the news."

Three years ago, his adult son — who had been diagnosed as schizophrenic — stabbed an 80-year-old man in the back.

Despite the effort Nichols devoted to getting help for his son, he was unsuccessful, and Ryan Patrick Nichols is now serving a 15-year prison sentence.

"As the parent of a person who is mentally ill, there is always the fear of being judged that there was something more you could or should have done," he said. "But most parents I know are doing the best they can to get service."

The Dec. 14 killings of 20 children and six adults at an elementary school in Newtown, Conn., have reignited demands for improved services for the mentally ill, especially for adolescents and young adults.

"Our mental-health system has completely abandoned people with the most serious mental illnesses, their families and communities," said executive director Doris Fuller. "Until their needs are addressed, tragedy is predictable."

Adam Lanza, the 20-year-old shooter in the Newtown massacre, is said to have struggled with emotional or psychological problems. Lanza, who also killed his mother, committed suicide at the school. The state medical examiner was told that Lanza had Asperger's syndrome, although that developmental disorder has not been linked to violent behavior.

Jared Lee Loughner, who last month was sentenced to life in prison for killing six people and wounding 13 others, including U.S. Rep. Gabrielle Giffords, outside a Tucson grocery store Jan. 8, 2011, is schizophrenic.

Jill Withers, left, daughter-in-law of Dean Withers, hugs Dean's granddaughter Lacey Griffith before a news conference at the Westminster police station in 2009 after then-26-year-old Ryan Nichols, below right, who had struggled with schizophrenia for years, stabbed 80-year-old Dean Withers, below left, at a King Soopers. (Hyoung Chang, Denver Post file)

Comilla Sasson, an emergency-room doctor at the University of Colorado Hospital, cared for many victims of the Aurora shooting.

"We don't want to have tragedy define policy," she said, "but at some point we have to stand up and say, 'The system is broken.' "

The general public has no idea how hard it is to get someone suffering from mental illness into treatment, Fuller said.

"The first obstacle that people run into is being told that he or she is not dangerous and to bring them back when they are," she said.

Dean Withers, 80, the King Soopers employee who was stabbed in the parking lot, allegedly by Ryan Nichols (HANDOUT | )

In Colorado, even the most devoted parents face a gantlet of barriers — laws that make it difficult for them to make decisions for children over 18, psychiatrists who don't take Medicaid or accept new patients, insurance companies that don't adequately cover mental illness, and a 77 percent drop in the number of psychiatric beds for adolescents over the past two decades, to fewer than 200 today from 900 in the early 1990s.

Because mental illness remains so stigmatized, parents are often isolated. They're ashamed to talk about it or have learned that friends don't know how to respond or can't cope.

So, in private, they deal with brutal realities: kids who smash fists through walls, kill the family pets, threaten to stab siblings or, in a psychotic rage, claim they're going to kill everyone. Some parents have put alarms on bedroom doors for fear of being killed in their sleep. Others are terrified after a call from the emergency room informing them their child is being released back to their custody because no psychiatric bed is available.

"The response they constantly get is, 'Next time, call the police and press charges,' " Barber said. "But for families, that is not acceptable. They don't want to have a kid locked up. They want to get help for them."

Nichols struggled with this for years.

"One of the hardest things is to call the police on your own child, who is mentally ill," he said.

He once had to talk a police officer out of Tasering his son after he had punched a hole in the wall of the family home.

Because Ryan didn't quality for Medicaid, Nichols got him onto his health-care plan.

"But his psychiatrist there said to me, 'We don't have the comprehensive services your son needs,' " Nichols said.

At one point, he asked police to take Ryan to a hospital for a 72-hour hold and got a crisis evaluation.

"That was OK," he said, "but what about the long term? We were kind of left with, 'Now what?' "

He tried to get help from social services, "but I learned there really weren't any services, just day programs or counseling, nothing more long-term like they have for the developmentally delayed population."

At age 26, Ryan was living at home with his parents and seemed to be doing OK — though it was a daily battle to get him to take his anti-psychotic medication.

One day, he walked over to King Soopers and stabbed an 80-year-old employee.

"Now, the prison is taking over his long-term care," Nichols said.

Ryan tells his father that the psychiatrist at Arkansas Valley Correctional Facility said he didn't need to take medication, but his father wonders whether that is really true.

His son will be eligible for parole in 12 years, when Nichols will be 67.

"When he paroles out, what if he doesn't take his medication?" Nichols said. "Where will he live if my wife and I aren't able to care for him? Will the services be there?"

"It takes an incredible amount of time to find the resources," she said. "Lots of phone calls, lots of meetings. It's mind-boggling to figure out the system and where to go."

When her son was in crisis, she often took him to an emergency room.

"He'd be in the hospital for two or three days, then they'd let him back out," Bishop said. "He wasn't stabilized, but they had no beds. I went through the same thing over and over."

Once, she was told they were releasing her son without giving him any medication.

"I was really upset. I called back the next day to find out where he was, but they couldn't tell me because of HIPAA. I had to wait till Monday, when his therapist called to tell me he was threatening to take off to California," Bishop said. "I was so scared because if he took off, I'd never find him."

According to a report in a February 2012 issue of Emergency Physicians Monthly called "The Depressing State of Psychiatric Care in the ED," the absolute number of inpatient psychiatric beds in the U.S. decreased by more than 60 percent between 1970 and 2002. The biggest loss was from state and county hospitals, where bed counts dropped by 90 percent.

"We do see a problem with kids, usually teens, because there seem to be even less facilities available," said David Ross, an emergency-room doctor at Penrose-St. Francis Hospital in Colorado Springs.

"No one wants to stick them with adult psychiatric patients, but it's a quandary for us," he said. "Often we find a way for them to go home. It may be a bit shaky if it will be successful there, but there is no place to send them."

If a bed is located, it may be in a distant part of the state.

"We're casting such a wide net because there's such a low number of beds," CU's Sasson said. "It rips the family apart. They already have to deal with psychiatric issues, then they may have to drive to Greeley to see (the child). But we're trying to get access to any bed, anywhere."

Eventually, Bishop found help through the Jefferson Center for Mental Health. Her son stayed in its treatment facility for nine months.

"It took a burden off me because I knew he was safe and being taken care of," she said.

They helped find him Section 8 housing, and he has been successfully living on his own for four years.

Bishop offers families hope, saying that if they can get their troubled child into treatment long enough to become stable, "they actually can have insight into their illness and are able to move forward into recovery."

But as a parent of a mentally ill child, she says her job is never over.

"I constantly monitor my son," she said. "It's just a normal thing we do as parents. When they're possibly in danger, we're going to protect them."

The Family-to-Family Education Program offered by the National Alliance on Mental Illness is a free, 12-week course that teaches coping skills to family members of people with serious mental illness. More than 300,000 people have taken this course, and it is offered at 19 different locations in Colorado.

There is also Colorado Visions, a free five-week course for caregivers of children and adolescents with mental illness or serious emotional disorders. A new series will start soon at Children's Hospital.

To get information on the date, or learn about the locations for Family-to-Family, call 303-518-1289 or

303-321-3104. The webite namicolorado.org is full of help and information.

For an immediate crisis, call Metro Crisis Line at 888-885-1212.

If you need to call the police about a mentally disturbed family members, always ask for a CIT, or crisis-trained police officer. They know how to help best.

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